{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T06:25:14Z","timestamp":1792650314851,"version":"4.5.0"},"posted":{"date-parts":[[2026,9,13]]},"group-title":"Infectious Diseases (except HIV\/AIDS)","reference-count":0,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T00:00:00Z","timestamp":1789257600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.medrxiv.org\/about\/FAQ#license"}],"funder":[{"award":["5R01AI173333"],"award-info":[{"award-number":["5R01AI173333"]}],"id":[{"id":"https:\/\/ror.org\/043z4tv69","id-type":"ROR","asserted-by":"publisher"}]},{"award":["Postdoctoral Research Fellowship to C.M.C."],"award-info":[{"award-number":["Postdoctoral Research Fellowship to C.M.C."]}],"id":[{"id":"https:\/\/ror.org\/038cgyc59","id-type":"ROR","asserted-by":"publisher"}]},{"name":"National CMV Foundation","award":["PIDS Fellowship Award to F.S."],"award-info":[{"award-number":["PIDS Fellowship Award to F.S."]}]},{"award":["Early Career Award to F.S."],"award-info":[{"award-number":["Early Career Award to F.S."]}],"id":[{"id":"https:\/\/ror.org\/03hnrwx04","id-type":"ROR","asserted-by":"publisher"}]},{"award":["1UM1TR005436"],"award-info":[{"award-number":["1UM1TR005436"]}],"id":[{"id":"https:\/\/ror.org\/04pw6fb54","id-type":"ROR","asserted-by":"publisher"}]},{"award":["UL1TR001873"],"award-info":[{"award-number":["UL1TR001873"]}],"id":[{"id":"https:\/\/ror.org\/04pw6fb54","id-type":"ROR","asserted-by":"publisher"}]},{"award":["UL1TR000040"],"award-info":[{"award-number":["UL1TR000040"]}],"id":[{"id":"https:\/\/ror.org\/04pw6fb54","id-type":"ROR","asserted-by":"publisher"}]},{"name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","award":["UG1 HD40500"],"award-info":[{"award-number":["UG1 HD40500"]}]},{"name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","award":["U24 HD36801"],"award-info":[{"award-number":["U24 HD36801"]}]},{"name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","award":["UG1 HD53097"],"award-info":[{"award-number":["UG1 HD53097"]}]},{"name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","award":["UG1 HD40512"],"award-info":[{"award-number":["UG1 HD40512"]}]},{"name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","award":["UG1 HD40485"],"award-info":[{"award-number":["UG1 HD40485"]}]},{"name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","award":["UG1 HD34208"],"award-info":[{"award-number":["UG1 HD34208"]}]},{"name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","award":["UG1 HD40560"],"award-info":[{"award-number":["UG1 HD40560"]}]},{"name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","award":["UG1 HD27869"],"award-info":[{"award-number":["UG1 HD27869"]}]},{"name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","award":["UG1 HD27915"],"award-info":[{"award-number":["UG1 HD27915"]}]},{"name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","award":["UG1 HD68258"],"award-info":[{"award-number":["UG1 HD68258"]}]},{"name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","award":["UG1 HD68282"],"award-info":[{"award-number":["UG1 HD68282"]}]},{"name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","award":["UG1 HD40544"],"award-info":[{"award-number":["UG1 HD40544"]}]},{"award":["UG1 HD40545"],"award-info":[{"award-number":["UG1 HD40545"]}],"id":[{"id":"https:\/\/ror.org\/04byxyr05","id-type":"ROR","asserted-by":"publisher"}]},{"award":["UG1 HD68268"],"award-info":[{"award-number":["UG1 HD68268"]}],"id":[{"id":"https:\/\/ror.org\/04byxyr05","id-type":"ROR","asserted-by":"publisher"}]},{"award":["UG1 HD34116"],"award-info":[{"award-number":["UG1 HD34116"]}],"id":[{"id":"https:\/\/ror.org\/04byxyr05","id-type":"ROR","asserted-by":"publisher"}]},{"award":["UG1 HD87192"],"award-info":[{"award-number":["UG1 HD87192"]}],"id":[{"id":"https:\/\/ror.org\/04byxyr05","id-type":"ROR","asserted-by":"publisher"}]},{"award":["UG1 HD87230"],"award-info":[{"award-number":["UG1 HD87230"]}],"id":[{"id":"https:\/\/ror.org\/04byxyr05","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,9,13]]},"abstract":"<jats:p>\n                  BACKGROUND\nHuman cytomegalovirus (HCMV) is the leading global infectious cause of birth defects. Despite its prevalence as a cause of life-long disabilities, there are no licensed vaccines to prevent congenital CMV (cCMV), and correlates of protection remain poorly understood. To address this, we identified humoral immune responses to primary HCMV infection during early pregnancy associated with odds of vertical transmission. \n\nMETHODS\nMaternal plasma was collected from a trial that screened &gt;200,000 and enrolled 399 pregnant women serologically diagnosed with primary HCMV infection prior to randomization for hyperimmunoglobulin or placebo therapy (\n                  <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT01376778\">NCT01376778<\/jats:ext-link>\n                  ), where 78 transmitted cCMV. Plasma IgG, IgM, and IgA binding to HCMV antigens, neutralization, antibody-dependent cellular phagocytosis, and inhibition of cell-associated viral spread were measured and related to transmission outcome.\n\nRESULTS\nIn a case-control conditional logistic regression, IgM binding to HCMV entry glycoproteins was associated with increased odds of cCMV, identifying potential biomarkers of congenital infection. In contrast, IgG binding to UL16, UL141, prefusion-like gB, gB antigenic domains (AD) 4+5, and gH\/gL were associated with decreased odds of cCMV. Surprisingly, IgG binding to the immunodominant gB AD-1 region, pp150, and cell-associated gB were associated with increased odds of cCMV. A LASSO regression model selected IgG responses against UL16 and gB AD-4+5 as associated with decreased odds of transmission, suggesting their potential importance as vaccine targets. \n\nCONCLUSION\nUL16 and domain specificity of gB-specific IgG responses differentially impact cCMV odds following acute infection, emphasizing the importance of rational antigen selection and gB conformation for HCMV vaccine design to eliminate cCMV.\n                <\/jats:p>","DOI":"10.64898\/2026.09.10.26362772","type":"posted-content","created":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T20:55:11Z","timestamp":1789332911000},"source":"Crossref","is-referenced-by-count":1,"title":["Maternal Antibodies to Primary CMV Infection Link to Fetal Transmission"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3874-4577","authenticated-orcid":false,"given":"Chelsea M","family":"Crooks","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Weill Cornell Medicine, New York, NY;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard T","family":"Barfield","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adelaide S","family":"Fuller","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Weill Cornell Medicine, New York, NY;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brenna L","family":"Hughes","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Duke University, Durham, NC;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geeta K","family":"Swamy","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Duke University, Durham, NC;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergey","family":"Ananyev","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Weill Cornell Medicine, New York, NY;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Libby","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Weill Cornell Medicine, New York, NY;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan R","family":"Connors","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Weill Cornell Medicine, New York, NY;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1808-6688","authenticated-orcid":false,"given":"Krithika P","family":"Karthigeyan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Weill Cornell Medicine, New York, NY;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire E","family":"Otero","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Weill Cornell Medicine, New York, NY;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frances","family":"Saccoccio","sequence":"additional","affiliation":[{"name":"Childrens Hospital of Richmond at VCU, Richmond, VA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Eudailey","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Weill Cornell Medicine, New York, NY;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolyn","family":"Weinbaum","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Weill Cornell Medicine, New York, NY;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cliburn","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1438-4554","authenticated-orcid":false,"given":"Sallie R","family":"Permar","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Weill Cornell Medicine, New York, NY;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"54368","container-title":[],"original-title":[],"link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.64898\/2026.09.10.26362772","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T20:55:11Z","timestamp":1789332911000},"score":1,"resource":{"primary":{"URL":"http:\/\/medrxiv.org\/lookup\/doi\/10.64898\/2026.09.10.26362772"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,13]]},"references-count":0,"URL":"https:\/\/doi.org\/10.64898\/2026.09.10.26362772","relation":{},"subject":[],"published":{"date-parts":[[2026,9,13]]},"subtype":"preprint"}}